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Stomach Surgery for Weight Loss

By Laurie Beebe, MS, RD, LD ; Updated July 18, 2017

Surgery for weight loss comes with risks, just like any other surgery. Each surgery candidate must weigh the benefits and drawbacks with a physician or surgeon who is an expert in the field. The altering of the capacity for stomach contents is just one tool in the fight against weight loss. After surgery there will need to be major lifestyle changes made to keep healthy.

Permanent Surgery

Gastric bypass and stomach stapling are irreversible operations performed to promote weight loss. In gastric bypass surgery a part of the stomach is cut out or stapled off to leave a small pouch for holding food. This severely limits the amount a person can eat at one sitting. The stomach pouch is re-connected to a lower section of the small intestine. A significant portion is bypassed, preventing food from being properly digested and absorbed. This results in poor absorption of calories, leading to large amounts of weight loss.

Reversible and Adjustable Procedures

In banding or balloon placement, a device is placed around the stomach and tightened, leaving a small pouch in the upper portion of the stomach to hold food and a narrow passageway to the lower portion of the stomach. The digestive system functions normally but there is extremely limited capacity for the amount of food that can be eaten at one time. Bands or balloons can be loosened or tightened to allow more or less food intake if a person is not losing weight at the desired rate.

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Candidates for Stomach Surgery

The Mayo Clinic reference on gastric bypass surgery summarizes candidates as those “who are unable to achieve or maintain a healthy weight through diet and exercise, are severely overweight, and who have health problems as a result.” This is true for gastric banding as well. For most surgical centers, like the Lap Band Solutions group in Texas, patients are required to have a body mass index (BMI) of 40 or higher. This number is calculated using height and weight and is the equivalent of being close to 100 pounds over ideal weight. Other candidates qualify for weight loss surgery at a BMI between 35 and 40 if they also have coexisting health problems that can be alleviated with weight loss.

The Diet After Weight Loss Surgery

With any of these procedures the stomach is left with the capacity of just a few ounces, and also with a narrower opening to the small intestine. Food must be liquefied for several days after surgery and then pureed for up to a few weeks longer. Eventually solid foods can be eaten but must be chewed very well to avoid vomiting or possibly obstructing the stomach outlet. Large portions will never be part of the daily diet.

Weight Loss Results

Medline reports weight loss of 10 to 20 pounds per month in the first year after gastric bypass surgery. Weight loss is slower with gastric banding and ultimately only one-third to one-half of the excess weight may be lost.

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